Little guidance exists for medical educators on preventing misuse of digital media (social networking, blogs and media share sites) and ensuring standards for professional conduct. This study aims to assess digital media use frequency, perceptions regarding misuse, and professional standards among trainees. A 17-item anonymous survey was developed and distributed to medical students, residents, and fellows at a single institution to assess familiarity, use, and perceptions of digital media policy. Trainees agreed that physicians are obligated to represent themselves professionally in publicly viewed forums (greater 60% among all trainees). Frequent users perceived regulation of personal use as a privacy infringement (super-user 74% vs. non-super-user 49%; p < .001) but were more likely to state that physicians are obligated to represent themselves professionally (super-user 66% vs. non-super-user 44%; p < .003). Thus, it was found that frequency of use is associated with increased likelihood of opposition to regulation. All users, regardless of training level, believe in maintaining professional demeanor on these sites.